Do you have neck or back pain? Sometimes, it’s hard to know exactly where it’s coming from. An injection called a medial branch block can help your medical provider figure out if tiny nerves in your spine are causing the problem. This information can guide additional treatment. Summit Orthopedics spine specialists perform medial branch blocks across the Minneapolis/St. Paul area to put patients on the path to pain relief.
What Is a Medial Branch Block?
A medial branch block is an injection of local anesthetic to numb tiny nerves in your spine. These nerves are called medial branch nerves. They send pain messages from small joints in your spine, called facet joints, to your brain.
If a medial branch block injection makes your pain go away for a little while, it means those joints are likely causing the pain. If the shot helps, you might be a good fit for another treatment called radiofrequency ablation[1] . This therapy uses heat to sever the tiny nerves that cause pain. If the medial branch injection doesn’t help, it means your pain is probably coming from somewhere else.
You can get a medial branch injection at any level of the spine. Cervical medial branch blocks help with pain in the neck (cervical spine). Thoracic medial branch injections treat problems in the middle back. Lumbar medial branch blocks provide relief in the lower back. You might hear this called lumbar MBB.
A medial branch nerve block is different from a cortisone injection or an epidural steroid injection. Those shots use steroid medicine to treat pain. Medial branch injections use a numbing medication or local anesthetic to briefly stop pain and find out why you hurt.
How Does a Medial Branch Block Help?
A medial branch injection can make you feel better for only a short time. The biggest benefit, though, is what you and your spine specialist can learn about your pain.
If the injection works, you can try radiofrequency ablation, which may stop the pain for longer. If the injection doesn’t help, your medical provider knows to look for other sources of your pain.
Your medical provider may suggest a medial branch block injection if they think your pain comes from the facet joints. They may want you to try medications or physical therapy first. If those don’t work, you might get a medial branch block.
What to Expect
Before the injection, think about what movements or activities make your back or neck hurt. You’ll need to do those things before and after the injection to see if it helped. The shot itself only takes 10–15 minutes, and you’ll go home the same day.
Before the Shot
- Get someone to drive you to and from the procedure center.
- Don’t schedule a colonoscopy or dental procedure for 48 hours before or after the medial branch block.
- Don’t take pain medicines for four to six hours before the shot.
- Tell the care team about any allergies, medicines you take or medical devices you have (like a pacemaker).
- Tell your care team if you feel sick before your procedure. If you do, they can change your appointment.
If you will get medicine to help you relax (sedation), don’t eat solid foods for six hours before the shot. Don’t drink liquids or have gum or candy for two hours before.
During the Procedure
You might get medicine to relax you. You will lie face down on an X-ray table. Your provider will clean and numb the injection site.
Your spine specialist will:
- Use fluoroscopy (a special X-ray) to guide a small needle to the nerves they want to numb
- Inject contrast dye to make sure the numbing medication goes to the right spot
- Place the local anesthetic over the nerves
- Take out the needle and bandage the injection site
After the shot, you’ll rest for five to 10 minutes before going home.
What Are the Side Effects?
Sometimes, a medial branch block can cause side effects, such as:
- An allergic reaction to the numbing medication or contrast dye
- Bleeding
- Infection
- Nerve injury
- Temporary pain at the injection site
Recovery
The effects of the medial branch block will only last a few hours to a few days. In the hours after the injection, try to do things that usually cause your pain. If you feel less or no pain, the injection helped. Keep track of how you feel and tell your spine specialist. If the injection worked, your physician may schedule you for a radiofrequency ablation.
You can go back to your normal activities the day after your injection.
Medial Branch Block at Summit Orthopedics
At Summit Orthopedics, we’re committed to providing the most pain relief using the least invasive techniques possible. To do that, we need accurate diagnostic information, and medial branch blocks can provide it. Our experts routinely use this procedure to pinpoint the cause of neck or back pain. It’s all part of how we personalize care to deliver the most effective treatment.
Summit Orthopedics surgeons are available at nearly 30 convenient locations across the Minneapolis/St. Paul metro area, serving Minnesota and western Wisconsin. Our state-of-the-art, comprehensive orthopedic centers offer same-day appointments from a team of experts who offer the full scope of orthopedic care.
Find your Summit Orthopedics back, neck and spine care expert, request an appointment, or call us at (651) 968-5201 to schedule a consultation.
